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Personality and Pain Outcomes in Rheumatic Disease: The Mediating Role of Psychological Flexibility.Healthcare (Basel, Switzerland) May 2024Chronic pain is associated with increased disability and vulnerability to emotional disorders. Personality and psychological flexibility (PF) describe interindividual...
BACKGROUND
Chronic pain is associated with increased disability and vulnerability to emotional disorders. Personality and psychological flexibility (PF) describe interindividual differences that shape the adjustment to chronic pain. Specifically, PF was found to be associated with pain, fatigue, anxiety, and depression intensity. Although previous studies established strong correlations between personality and pain outcomes, evidence on the nature of this relationship is scarce. Therefore, the objective of this study is to explore the mediating effect of PF on the relationship between personality and distress.
METHODS
This transversal study included 108 participants (age M = 56.7, SD = 11.3) diagnosed with musculoskeletal chronic pain. Self-reported measures were administered by the medical care team. Multiple mediation models were performed for estimating the indirect effects on each outcome variable.
RESULTS
After controlling for age and gender covariates, we found that PF completely mediated the relationship between personality traits and all pain outcomes and partially mediated the impact of extraversion on anxiety. In addition, emotional stability also had an indirect effect on anxiety through PF.
CONCLUSIONS
Personality traits and PF are significant predictors of pain outcomes. PF represents a core process mediating the impact of personality traits on the perceived intensity of pain, fatigue, anxiety, and depression in patients with rheumatic disease. These results could facilitate the application of individualized psychological interventions in clinical contexts targeting the reduction of emotional avoidance and in chronic pain patients.
PubMed: 38891162
DOI: 10.3390/healthcare12111087 -
Healthcare (Basel, Switzerland) May 2024(1) Background: Illness perception (IP) is an important psychological construct for couples dealing with cancer, which impacts health outcomes and the psychological...
(1) Background: Illness perception (IP) is an important psychological construct for couples dealing with cancer, which impacts health outcomes and the psychological adjustment to cancer. More research is needed to explore the traits of IP and the efforts of couples coping with cancer. Thus, this study was designed to explore the coping experiences and features of the IPs of couples dealing with cancer. (2) Methods: A total of 24 patients with colorectal cancer (CRC) and 20 spousal caregivers (SCs) participated in semi-structured interviews. All interviews were recorded digitally, transcribed, and analyzed by using an inductive thematic analysis. (3) Results: Two themes (individualized and predominant IP; IP sharing and restructuring) were developed. A preliminary framework was formulated to illustrate the relations among subthemes and the relations between themes with an adjustment of a positive IP to CRC. In this framework, based on multiple sources and factors, the natural disparities formed the IPs of the partners of couples and determined the incongruence of IPs. The effects of IP incongruence on lives under the disease guided the three directions of coping approaches (i.e., information and available support, appropriate disclosure and reflection, and leaving the CRC diagnosis behind) which were adopted by couples dealing with CRC to share and restructure the IP with their spouses for effective dyadic coping. (4) Conclusions: This study provides insights to healthcare providers into the experiences of couples dealing with CRC and the development of couple-based IP intervention programs: (a) it initially provides adequate factual knowledge for enhancing beliefs in the ability to control illness, (b) encourages illness-centered conversations and disclosure regarding thoughts and emotions for promoting positive congruence of IP between the partners of couples dealing with a hard dilemma, and (c) guides couples to perceive positive changes and explore the illness's meaning. Understanding each theme of personalized IP and adopting effective IP coping approaches can help guide couples dealing with CRC to efficiently promote constructive IP and better health outcomes.
PubMed: 38891148
DOI: 10.3390/healthcare12111073 -
Psychiatry and Clinical... Mar 2024This study aims to examine the levels and the relationship between resilience and marital adjustment in mothers of a child diagnosed with autism spectrum disorder.
BACKGROUND
This study aims to examine the levels and the relationship between resilience and marital adjustment in mothers of a child diagnosed with autism spectrum disorder.
METHODS
Seventy mothers with a child diagnosed with autism spectrum disorder who have been followed up in the Child and Adolescent Psychiatry Outpatient Clinic of Bakırköy Training and Research Hospital for Psychiatry Neurology and Neurosurgery and 74 mothers with a typically developing child to form the control group were included in the study. The Childhood Autism Rating Scale was applied to assess the severity of autism symptoms in children. Sociodemographic form, Beck Depression Scale and Beck Anxiety Scale were applied. The Psychological Resilience Scale for Adults was used to assess resilience. The Marital Adjustment Scale was applied to evaluate the participants' marital adjustment.
RESULTS
The level of resilience ( < .001) and marital adjustment ( = .002) in mothers of children with autism spectrum disorder were found to be lower when compared to mothers with a typically developing child. There is a negative correlation between the level of resilience and the severity of autism ( = .002) ( = -0.361). A positive correlation was found between marital adjustment and resilience ( < .001) ( = 0.465). High levels of depressive symptoms ( = .003), low marital adjustment ( = .003), and low educational level were found to be predictive of low resilience ( = .044).
CONCLUSION
Taking advantage of the fact that resilience is a dynamic process, there is a need to develop strategies to increase resilience in mothers of children with autism spectrum disorder, which will also give rise to individual and marital well-being.
PubMed: 38883886
DOI: 10.5152/pcp.2023.22592 -
Journal of the American Heart... Jun 2024Hypertrophic cardiomyopathy is a burdensome condition that inflicts both physical and psychological impairment on those with the disease, negatively impacting... (Observational Study)
Observational Study
BACKGROUND
Hypertrophic cardiomyopathy is a burdensome condition that inflicts both physical and psychological impairment on those with the disease, negatively impacting health-related quality of life (HRQoL). Given the abundance of evidence suggesting a role of physical activity (PA) in modulating HRQoL in healthy populations of children, we sought to determine the relationship between HRQoL and PA in children diagnosed with hypertrophic cardiomyopathy.
METHODS AND RESULTS
A multicenter prospective observational cohort study was conducted, with patients with hypertrophic cardiomyopathy aged 10 to 19 years being provided a wrist-worn activity tracker (Fitbit Charge HR) to wear for 14 days. Patients self-reported on Pediatric Quality of Life 4.0 quality of life inventory items, which were associated with PA metrics following covariate adjustment using linear regression. A total of 56 participants were recruited to the study. The median age at enrollment was 15.5 years (interquartile range, 13.8-16.8), and 16 out of 56 (29%) of the cohort were girls. The cohort reported decreased metrics of physical, psychosocial, and total summary scores compared with health reference populations, with scores comparable with that of published populations with chronic disease. Increased physical HRQoL scores were significantly associated with increased daily steps taken, distance traveled, and flights of stairs climbed.
CONCLUSIONS
These results show that impaired PA correlates with reduced HRQoL in children with hypertrophic cardiomyopathy, suggesting PA may partially mediate HRQoL in this population.
Topics: Humans; Quality of Life; Female; Adolescent; Cardiomyopathy, Hypertrophic; Male; Prospective Studies; Child; Exercise; Young Adult; Fitness Trackers; Health Status
PubMed: 38879453
DOI: 10.1161/JAHA.123.033968 -
Journal of Affective Disorders Jun 2024This study aims to describe maternal depressive symptoms (MDS) trajectories in a longitudinal study extending from pregnancy to 27 years after the birth of the...
BACKGROUND
This study aims to describe maternal depressive symptoms (MDS) trajectories in a longitudinal study extending from pregnancy to 27 years after the birth of the firstborn child. We also explored the associations of both MDS trajectories and child internalizing and externalizing problem trajectories with maternal adjustment (adaptive functioning, emotional and behavioral problems).
METHODS
The population-based study was conducted in Tampere, Finland, and the sample comprised 356 first-time mothers. MDS were screened with the Edinburgh Postnatal Depression Scale during pregnancy, first week after delivery, 2 and 6 months postnatally, and when the child was 4-5, 8-9, 16-17, and 26-27 years of age. The internalizing and externalizing problems of the children were assessed with the Child Behavior Checklist when the child was 4-5, 8-9, and 16-17 years of age. Maternal adaptive functioning and internalizing and externalizing problems were assessed with the Adult Self Report at 26-27 years after the birth of the first child. Complete follow-up data were available for 168 mothers.
RESULTS
We describe a three-group trajectory model of MDS (High Stable, Low Stable, Very Low). Elevated depressive symptom patterns were associated with less optimal maternal outcomes regarding both adaptive and problem dimensions. The child's internalizing and externalizing problem trajectories were associated with maternal internalizing and externalizing problems but not with maternal adaptive functioning.
LIMITATIONS
Maternal and child measures were based on maternal reports only.
CONCLUSIONS
The interconnectedness of the well-being of the mother and child should be noted in health and mental health services for adults and children.
PubMed: 38876318
DOI: 10.1016/j.jad.2024.06.027 -
Frontiers in Psychology 2024Patients with cancer experience significant psychosocial distress. Stressors include interpersonal difficulties like loneliness, isolation, thwarted belongingness,...
OBJECTIVE
Patients with cancer experience significant psychosocial distress. Stressors include interpersonal difficulties like loneliness, isolation, thwarted belongingness, communication impediments, and conflicts. Interventions are required that address their specific psychosocial needs. Interpersonal Psychotherapy (IPT) is a promising concept for the treatment of psychosocial distress associated with cancer because it addresses patients' interactions and role transformations. This review aims to provide an overview of the current evidence regarding interventions for patients with cancer based on IPT.
METHODS
A systematic review following PRISM guidelines was conducted, including randomized controlled trials of IPT-based interventions in patients with cancer, assessing effects on distress, depression, and anxiety.
RESULTS
Eight studies were included, sampling 390 patients in total. Seven out of eight studies assessed exclusively women with breast cancer. Two studies described IPT interventions and showed stronger improvement in depression and anxiety compared to TAU and equal improvement in depression compared to other psychotherapy interventions. Six studies described remote Interpersonal Counselling (IPC). One found remote IPC to be superior to control conditions regarding depression, and one found remote IPC to be superior to attention control, but not active control conditions. No study found remote IPC to be superior to control conditions regarding distress.
DISCUSSION
There are few randomized controlled trials of IPT for patients with cancer. Results regarding depression and anxiety are promising for in-person IPT, but mixed for remote IPC.
CONCLUSION
The review suggests in-person IPT, but not remote IPC, may yield benefits for patients with cancer. Research on the subject is scarce, and to inform implementation of IPT interventions, research with diverse groups of patients with cancer is required.
SYSTEMATIC TRIAL REGISTRATION
PROSPERO, Identifier CRD42023410687.
PubMed: 38873503
DOI: 10.3389/fpsyg.2024.1367807 -
Blood Cancer Journal Jun 2024Childhood acute lymphoblastic leukemia (cALL) survivors suffer early-onset chronic diseases classically associated with aging. Normal aging is accompanied by organ...
Childhood acute lymphoblastic leukemia (cALL) survivors suffer early-onset chronic diseases classically associated with aging. Normal aging is accompanied by organ dysfunctions, including immunological ones. We hypothesize that thymic immunosenescence occurs in cALL survivors and that its severity may correlate with early-onset chronic diseases. The PETALE study is a cALL survivor cohort with an extensive cardiovascular and metabolic evaluation. The thymic immunosenescence biomarker, signal joint T-cell receptor excision circles (TREC), was evaluated and was highly correlated with age in healthy participants (n = 281) and cALL survivors (n = 248). We observed a systematic thymic immunoage accentuation in each cALL survivor compared to controls ranging from 5.9 to 88.3 years. The immunoage gain was independent of age at diagnosis and treatment modalities and was more severe for females. Thymic aging was associated with several pathophysiological parameters, was greater in survivors suffering from metabolic syndrome, but there was no significant association with global physical condition. The decrease in TREC was independent from blood cell counts, which were normal, suggesting a segmental aging of the thymic compartment. Indeed, increased plasmatic T cell regulatory cytokines IL-6, IL-7 and GM-CSF accompanied high immunoage gain. Our data reveal that cALL or its treatment trigger a rapid immunoage gain followed by further gradual thymic immunosenescence, similar to normal aging. This leads to an enduring shift in accentuated immunoage compared to chronological age. Thus, accentuated thymic immunosenescence is a hallmark of cALL survivorship and TREC levels could be useful immunosenescence biomarkers to help monitoring the health of cancer survivors.
Topics: Humans; Female; Male; Child; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Adolescent; Adult; Thymus Gland; Child, Preschool; Young Adult; Aged; Middle Aged; Aged, 80 and over; Cancer Survivors; Immunosenescence; Survivorship
PubMed: 38871704
DOI: 10.1038/s41408-024-01071-1 -
Disability and Health Journal Jun 2024A congenital anomaly of the hand can affect both function and appearance, and places a stressful psychological burden on the family, especially parents. Surgery during...
"As a parent, I want to do more for my child": A phenomenological approach to understanding the experiences of parents involved in surgical decision-making for children with congenital hand anomalies.
BACKGROUND
A congenital anomaly of the hand can affect both function and appearance, and places a stressful psychological burden on the family, especially parents. Surgery during infancy may prevent later disabilities, but little is known of the importance of parents' involvement in these decisions in terms of psychological adjustment or treatment satisfaction.
OBJECTIVE
To understand parents' perceptions of involvement in their child's surgery for limb anomaly, and their preferences for the support of healthcare professionals. Results should lead to recommended interventions to improve familial adjustment to the child's condition.
METHODS
Qualitative data was collected from semi-structured confidential self-reported interviews of 35 parents (65.7 % mothers) of children who had received reconstructive surgery for congenital hand anomaly (at age 24.89 ± 9.26 months); interviews were coincident with the 1-month postoperative follow-up. The parents ranged in age, gender, educational background, economic status, and type of anomaly. Data analysis referenced Colaizzi's phenomenological approach.
RESULTS
The concerns of the parents were consolidated into three themes: attitudes toward Parental involvement in surgical decision-making; status of parental involvement in Surgical decision-making; and need for help and support.
CONCLUSIONS
Some parents were comfortable leaving surgical decisions entirely to the medical staff, but most preferred active participation and were disappointed at their lack of inclusion. The maximum benefit from surgery for congenital abnormalities in infancy is achieved when the parents and extended families have access to the expertise, skills, encouragement, and psychological support of healthcare providers.
PubMed: 38871575
DOI: 10.1016/j.dhjo.2024.101647 -
The Journal of Pain Jun 2024Several person variables predate injury or pain onset that increase the probability of maladjustment to pain and opioid misuse. The aim of this study was to evaluate the...
Several person variables predate injury or pain onset that increase the probability of maladjustment to pain and opioid misuse. The aim of this study was to evaluate the role of 2 diathesis variables (impulsiveness and anxiety sensitivity [AS]) in the adjustment of individuals with chronic noncancer pain and opioid misuse. The sample comprised 187 individuals with chronic noncancer pain. The hypothetical model was tested using correlation and structural equation modeling analyses. The results show a significant association between impulsiveness and AS and all the maladjustment variables, and between impulsiveness and AS and opioid misuse and craving. However, although the correlation analysis showed a significant association between adjustment to pain and opioid misuse, the structural equation modeling analysis showed a nonsignificant association between them (as latent variables). The findings support the hypothesis that both impulsiveness and AS are vulnerability factors for maladaptive adjustment to chronic pain and opioid misuse. PERSPECTIVE: This article adds to the empirical literature by including AS and impulsiveness as antecedent variables in a model of dual vulnerability to chronic pain maladjustment and opioid misuse. The findings suggest the potential utility of assessing both factors in individuals in the first stages of chronic pain.
PubMed: 38871145
DOI: 10.1016/j.jpain.2024.104606 -
Supportive Care in Cancer : Official... Jun 2024The purpose of this study was to assess participants' perceptions and experiences while participating in a Food is Medicine medically tailored meal plus intensive... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
The purpose of this study was to assess participants' perceptions and experiences while participating in a Food is Medicine medically tailored meal plus intensive nutrition counseling intervention to create a theoretical explanation about how the intervention worked.
METHODS
This interpretive qualitative study included the use of semi-structured interviews with active participants in a randomized controlled trial aimed at understanding how a medically tailored meal plus nutrition counseling intervention worked for vulnerable individuals with lung cancer treated at four cancer centers across the USA. During the 8-month long study, participants in the intervention arm were asked to be interviewed, which were recorded, transcribed verbatim, and analyzed using conventional content analysis with principles of grounded theory.
RESULTS
Twenty individuals participated. Data analysis resulted in a theoretical explanation of the intervention's mechanism of action. The explanatory process includes three linked and propositional categories leading to patient resilience: engaging in treatment, adjusting to diagnosis, and active coping. The medically tailored meals plus nutrition counseling engaged participants throughout treatment, which helped participants adjust to their diagnosis, leading to active coping through intentional self-care, behavior change, and improved quality of life.
CONCLUSIONS
These findings provide evidence that a Food is Medicine intervention may buffer some of the adversity related to the diagnosis of lung cancer and create a pathway for participants to experience post-traumatic growth, develop resilience, and change behaviors to actively cope with lung cancer. Medically tailored meals plus intensive nutrition counseling informed by motivational interviewing supported individuals' adjustment to their diagnosis and resulted in perceived positive behavior change.
Topics: Humans; Lung Neoplasms; Male; Female; Middle Aged; Counseling; Aged; Qualitative Research; Adaptation, Psychological; Quality of Life; Meals; Self Care
PubMed: 38869623
DOI: 10.1007/s00520-024-08616-x